NPI | 1689030330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: FL 6906834) |
Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier (Licence: FL CL1189677) |
Enumeration Date | 2016-01-11 |
Last Update Date | 2025-01-27 |